Short Attention Span Summary

PE - Not Just an Acute IllnessFibrinolysis is indicated for massive PE, and recent studies suggest it may also be helpful in reducing the incidence of chronic pulmonary hypertension in those with submassive PE (which makes one unable to exert without dyspnea...no more jogging or tennis). See this for an excellent review of pertinent studies. This study sheds more light on how common residual dyspnea is post-PE. At one year follow up, almost half the patients with PE had decreased VO2 and dyspnea, although echo findings had normalized in the dyspneic patients. Deconditioning could explain this, at least in part. There is not an action you should take based on this study. It is meant to create awareness that PE is not only an acute disease; it can lead to chronic dyspnea (not to mention the post-phlebitic leg pain that is common after large DVT).

Spoon FeedPE may cause chronic dyspnea in almost half of affected patients. As we learn more, we may be able to better target which people with submassive PE benefit from fibrinolysis.

Almost half of PE patients have exercise limitation at 1 year which adversely influences HRQOL, dyspnea and walking distance. CPET or 6MWD testing at 1-month may help to identify patients with a higher risk of exercise limitation at 1-year after PE. Based on our results, we believe that deconditioning that occurs after acute PE could underlie this exercise limitation, but cannot exclude that this may have been present pre-PE.